a Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina , USA.
b Department of Medicine, Division of General Internal Medicine , Duke University Medical Center , Durham , North Carolina , USA.
Subst Use Misuse. 2019;54(7):1178-1190. doi: 10.1080/10826084.2019.1568495. Epub 2019 Feb 6.
The emergency department (ED) is well-suited as an opportunity to increase treatment access for prescription opioid use disorder (POUD). We examined sex differences in ED utilization among individuals with POUD to understand potential sex-specific treatment barriers and needs.
Data from the 2005-2014 National Surveys on Drug use and Health were analyzed to examine the prevalence and correlates of past-year ED utilization among male and female adults aged 18 or older with POUD (n = 4412).
Overall, 58.2% of adults with POUD reported past-year ED utilization. Adjusted logistic regression revealed that females (vs. males) with POUD were more likely to report past-year ED utilization. Among females with POUD, older age, lower income, obtaining opioids from a physician, major depressive episode, and greater POUD severity were associated with increased odds of ED utilization. Among males with POUD, public insurance and obtaining opioids from a physician were associated with ED utilization. A larger proportion of males with POUD reporting ED use had multiple substance use disorders than those with no ED use. Treatment history (lifetime or past-year) for alcohol, drugs, or opioid use was associated with increased odds of ED use among males and females with POUD. Conclusions/Importance: Males and females with POUD presenting to the ED may have distinct predisposing, enabling, and need-related correlates. Sex-specific screening and intervention strategies may be useful to maximize the utility of the ED to address POUD.
急诊部（ED）非常适合作为增加处方类阿片使用障碍（POUD）治疗机会的场所。我们研究了 POUD 患者在急诊部的利用情况中的性别差异，以了解潜在的性别特异性治疗障碍和需求。
对 2005-2014 年全国毒品使用和健康调查的数据进行了分析，以调查过去一年中年龄在 18 岁或以上患有 POUD 的男性和女性成年人的 ED 利用情况的流行率和相关因素（n=4412）。
总体而言，58.2%的 POUD 患者报告过去一年中有 ED 就诊。调整后的逻辑回归显示，患有 POUD 的女性（与男性相比）更有可能报告过去一年中有 ED 就诊。在患有 POUD 的女性中，年龄较大、收入较低、从医生处获得阿片类药物、重性抑郁发作和 POUD 严重程度较高与 ED 就诊的可能性增加相关。在患有 POUD 的男性中，公共保险和从医生处获得阿片类药物与 ED 就诊相关。报告 ED 使用的患有 POUD 的男性中，有多种物质使用障碍的比例高于没有 ED 使用的男性。在患有 POUD 的男性和女性中，酒精、药物或阿片类药物的治疗史（终生或过去一年）与 ED 使用的可能性增加相关。结论/重要性：到 ED 就诊的患有 POUD 的男性和女性可能具有不同的倾向性、促成因素和与需求相关的因素。针对特定性别的筛查和干预策略可能有助于最大限度地发挥 ED 的作用，以解决 POUD 问题。
